eNews: July 15, 2020
MSSNY Peer to Peer (P2P) Program for Colleagues
The Medical Society of the State of New York is excited to offer to physicians, residents, and medical students the opportunity to talk with a peer about some of life stressors.
MSSNY’s Physician Wellness and Resiliency Committee has launched the MSSNY Peer to Peer (P2P) program for colleagues to avail themselves and reach out to peer supporters to discuss every daily stressors such as work, school, family, or financial stressors. And, with the advent of COVID-19 pandemic, there may also be some additional stress in our colleague lives.
The P2P program is an opportunity for our colleagues to have a one-time confidential discussion with a peer supporter. The peer supporter is a trained individual who can share experiences, listens without judgment, who can validate your feelings and provide you with Support, Empathy and Perspective.
Peer supporters can also provide information on organizations that can support you and will provide you with positive coping skills. They can also help connect you to organizations and individuals should you need more focused assistance.
Any physician, resident, or medical students who wishes to relate to a peer supporter, may contact the Medical Society of the State of New York in the following ways:
- MSSNY has established a separate email at P2P@mssny.org and requests that you be connected with a peer supporter
- Or you can call MSSNY at 1-844-P2P-PEER (844-727-7337) and request that you be connected with a peer supporter. The line is answered by MSSNY staff during regular business hours (Monday – Friday, 8:30-5 p.m.) and the call will be responded to by an MSSNY staff person. After 5 p.m. the call will be answering by a live answering service who will take down contact information for MSSNY staff to follow up with.
It is well documented that physicians, residents, medical residents have enormous stressors that can range from the emotions arising in the context of patient care to the environment in which we practice medicine. Now, with the COVID-19 pandemic, those stressors may be exacerbated.
Please know that you are not alone. MSSNY has trained peer supporters that are ready to support and take time to talk with you. Please reach out to us and know that we care about you and the issues that you face.
The words “Be Well” apply to all of us.
Bonnie Litvack, MD
MSSNY to HHS: CARES Act Provider Relief Fund for Survival of Practices
Physicians are essential to the health of their communities, as well as their economic well-being. Physicians contribute to their local economies and are important employers, providing jobs to nearly 700,000 New Yorkers according to a 2018 report from the American Medical Association. The fall-out from this crisis threatens to fundamentally alter the long-term stability of physician practices, and could lead to increased consolidation, which hurts competition and drives up costs for patients and employers.
The need is clear – our community-based physicians are important bedrocks of our communities and the nation’s economy. We urge you to do all in your power to ensure that adequate funds are allocated from the CARES Act Provider Relief Fund to help ensure the survival of community physician practices. Should you need additional resources to accomplish this, we stand ready to work with you to make that possible. Thank you for your continued work to address the COVID-19 pandemic and we look forward to continuing to work with you to serve the American people. Letter to Honorable Alex Azar II.
MSSNY Reaches Out to DOH re COVID-19 Tests Taking Too Long to Process
MSSNY has reached out to the New York State Health Department to raise concerns brought by some physicians that certain labs processing Covid-19 tests in some parts of the State, including one of the national lab companies, are reporting that it will take them over a week to complete and report testing results. What makes this particularly challenging for patients is that NYSDOH protocols for elective surgery require a negative Covid-19 test to be received within 5 days of the procedure. This means that some patients in need of medical care may not be able to receive the care they need.
An article in New York Daily News noted “some test results are taking a week or longer to reach patients”. During the Governor’s press briefing today, he noted that national laboratories are getting overwhelmed, but they process only 30% of New York’s testing. The Governor’s chief of staff also added that, as New York has a network of 215 labs performing tests with the typical turn-around time of 2-3 days for tests, patients could opt to use these other labs instead.
Quest Diagnostics Will Expedite Pre-Surgical Clearance
MSSNY EVP Phil Schuh asked our Socio-Med Division to check with Quest Diagnostics for information about their COVID test results turn-around time. Please see the attachment that should provide some clarity for their Priority Specimen Handling Program. Apparently, if the patient identifies that their test is related to pre-surgical clearance, the lab will expedite handling. The following is a press release from Quest: https://newsroom.questdiagnostics.com/COVIDTestingUpdates
When the physician obtains the COVID specimen which is sent to Quest, the physician needs to stress to the Quest lab that the test is part of pre-surgical clearance. When the patient goes to a testing site for a pre-surgical clearance, the patient needs to stress to the site that the test is for pre-surgical clearance. Quest indicated that they believe other labs have created similar protocols for pre-surgical clearance procedures. If the specimen is not treated as a priority, the physician can call 866MYQUEST to complain that a specific lab site is not compliant with Quest’s priority process.
Quest has only this one number for the entire US. Quest call center is divided into pods that service different parts of the country. The call will be directed to the appropriate pod that serves New York. If you have questions, call Regina McNally at 516-488-6100 ext.332. (Regina McNally, VP MSSNY Scio-Med Div.)
New Coronavirus Cases Shift to Affluent New York Neighborhoods
Coronavirus cases are popping up in more affluent Brooklyn and Manhattan neighborhoods that were not hard hit at the height of the pandemic, city health officials said Tuesday. As the infection rate rises among New Yorkers in their 20s, the geography of the virus has also shifted, with young adults now contracting the disease outside the working-class outer borough areas that have been the epicenter.
“We’re seeing cases in parts of Manhattan and parts of Brooklyn among that age group, that doesn’t exactly overlay with our poverty and racial disparities that we’ve seen in the past,” said Dr. Jay Varma, a senior adviser for public health in the mayor’s office.
As the pandemic cut a deadly course across the city, where it has killed more than 23,000 people, lower-income neighborhoods in the outer boroughs suffered the most cases and the most deaths. Latino and Black New Yorkers have died at twice the rate of whites.
The virus’ spread has decreased dramatically from its height, but the city is still seeing several hundred new cases each day. Total cases have stayed relatively flat, but data shows the infection rate is rising for New Yorkers in their 20s, while it is falling for people over 40. Neighborhoods in Manhattan and brownstone Brooklyn, which were largely spared earlier in the pandemic, are among those now seeing increases among young adults as the city reopens.
Officials pointed to young adults who had been quarantined at home venturing out and socializing more as the main driver of the uptick, though they have not identified exactly where the new cases are being transmitted. “People are now moving around more. They’re socializing more,” Varma said. “The most important way that we dropped transmission was to keep people separated from each other. People were essentially confined to their homes.”
Restaurants and bars reopened for outdoor service on June 22, and gatherings of up to 25 people are now legal as long as social distancing is maintained. Varma said it was “possible” people have gotten infected at recent protests police brutality but argued protests are unlikely to be the main cause. (Politico July 15)
List Prices for COVID-19 Tests Range: $20 to $850 at Large Hospitals Nationwide
A new KFF analysis of what large hospitals nationwide charge for out-of-network COVID-19 tests show a wide range of publicly posted prices — from $20 to $850 for a single test. In many cases, the prices exceed what Medicare pays for COVID testing, which is either $51 or $100 depending on the test.
Federal law now requires private insurers, Medicare and Medicaid to cover COVID-19 tests without any cost to the patient and provides funding to support free testing for some people without health insurance, though it does not guarantee access to no-cost tests for the uninsured. Those laws ensure that most people will not have to pay out of pocket for COVID tests, though limits to the federal requirements mean that some people with and without health insurance could receive bills for COVID-19 tests.
The analysis finds:
- The median price for a COVID-19 was $127, and about half of hospitals price their tests between $100 and $199. About one in five price their tests at more than $200.
- Some hospitals list a discounted rate for self-pay individuals, which range from $36 to $180. Other hospitals indicate that uninsured or self-pay individuals could receive free or discounted care through their financial assistance programs.
- Prices also vary for COVID-19 antibody tests, which are not used to diagnose active infections, from $35 to $300 at hospitals that list their prices.
The analysis set out to examine publicly posted prices at the two largest hospitals in each state and the District of Columbia. Although federal law requires hospitals to make COVID-19 prices publicly available on their websites, prices could only be found for 78 of the 102 hospitals examined. The prices reflect what they would charge for out-of-network services. Data on the negotiated rates for in-network services is not available. The analysis is part of the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.
The Risk of Dying From COVID-19-by Age, Sex. Weight and Ethnicity
A newly published study of more than 17 million people in England sheds light on how much a person’s age, race/ethnicity, body mass index, and more are correlated with their risk of dying from Covid-19. See the patterns on our interactive chart. (Advisory Board, July 13)
COVID-19 Study from FAIR Health Examines Patient Characteristics
FAIR Health released the fourth in its series of COVID-19 studies, Key Characteristics of COVID-19 Patients: Profiles Based on Analysis of Private Healthcare Claims. This new brief uses the nation’s largest repository of private healthcare claims to illuminate some of the key characteristics of patients diagnosed with COVID-19. These characteristics include age, gender, rural versus urban area by age, venue of care where first diagnosed, venue of care by age, comorbidities of hospitalized patients and median costs of hospitalization. The patient characteristics are analyzed nationally and by US census region. The data studied are from the period January-May 2020.
Among the findings:
- Nationally and in every US census region, chronic kidney disease and kidney failure were the most common comorbidity in hospitalized COVID-19 patients, accounting for 13 percent of all such patients.
- All regions except one resembled the nation in having type 2 diabetes as the second most common comorbidity; the exception, the South, had hypertension in that rank.
- Nationally, the median charge amount for hospitalization of a COVID-19 patient ranged from $34,662 for the 23-30 age group to $45,683 for the 51-60 age group. The median estimated in-network amounts ranged from $17,094 for people over 70 years of age to $24,012 for people aged 51-60 years.
- The West was the region with the widest range of costs for COVID-19 hospitalizations. There, median charge amounts ranged from $21,407 for the 19-22 age group to $93,459 for the over 70 age group. Median estimated in-network amounts ranged from $15,289 for the 19-22 age group to $60,205 for the over 70 age group.
- Nationally, an office was the most common setting for initial presentation of patients with COVID-19: 33.3 percent of COVID-19 patients presented to an office and 23.0 percent presented to an inpatient facility. However, older people (age 61 and above) most commonly presented first to an inpatient setting.
- In the Northeast, telehealth was more common for initial diagnosis of COVID-19 than emergency rooms (6.7 versus 6.2 percent of COVID-19 patients). The Northeast was the region with the highest percentage of COVID-19 patients who received their initial diagnosis via telehealth.
- Nationally, males were associated with a larger share (54 percent) of the distribution of COVID-19 claim lines than females (46 percent).
- The first brief in FAIR Health’s series on the COVID-19 pandemic examined projected US costs for COVID-19 patients requiring inpatient stays, the second the impact of the pandemic on hospitals and health systems, and the third the impact on healthcare professionals.For the new brief, click here.
Health Organizations Speak in Support of Dr. Anthony Fauci
Health and medical organizations are speaking out in support of Anthony Fauci, MD, a member of the White House’s coronavirus task force, as he is coming under attack from some members of the Trump administration, including the president himself.
“The AAMC is extremely concerned and alarmed by efforts to discredit Anthony Fauci, MD, our nation’s top infectious disease expert,” Association of American Medical Colleges President and CEO David J. Skorton, MD, and AAMC Chief Scientific Officer Ross McKinney, Jr., MD, said in a statement Monday. “America should be applauding Dr. Fauci for his service and following his advice, not undermining his credibility at this critical time.”
“The only way out of this pandemic is by following the science, and developing evidence-based prevention practices and treatment protocols as new scientifically rigorous data become available,” said Thomas File Jr., MD, president of the Infectious Diseases Society of America (IDSA), in a statement. “If we have any hope of ending this crisis, all of America must support public health experts, including Dr. Fauci, and stand with science.”
In addition to AAMC and IDSA, the HIV Medicine Association also weighed in on the issue. “We have been very fortunate to have Dr. Fauci at the helm directing infectious diseases research at NIH for so many years,” association chair Judith Feinberg, MD, said in a statement. “His leadership and support of a rigorous scientific process has been critical to transforming HIV from a death sentence to a chronic condition, saving millions of lives worldwide. His voice and expertise need to be amplified not silenced if we are going to get control of the COVID-19 pandemic, which has now taken the lives of more than 135,000 Americans and more than 570,000 people worldwide.”
Fauci’s last reported meeting with President Trump was during the first week of June, but he has no plans to leave his position, according to the Washington Post. Fauci is a civil servant and not a political appointee, meaning the White House cannot fire him directly. Dr. Fauci has been at his post since 1984 and has advised six presidents, according to his biography on the NIAID website. At the institute he oversees a budget of nearly $6 billion. (MedPage Today, July 14).
Please join the NYS Department of Health on
Thursday July 16th at 1-2PM for a COVID-19 update for healthcare providers
To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers.
AMA Statement on Trump Administration Decision on Student Visas
“The AMA is pleased that the Administration has reconsidered what would have been a setback for U.S. public and rural health. International medical students can now focus on their studies — rather than their immigration status — as they prepare to enter the health field and help fight this pandemic.” The following statement is attributable to: AMA President Susan R. Bailey, M.D.
School Reopening Guidance Includes Student Mask Requirements
Teachers and students will likely be required to wear masks or facial coverings in school buildings, under an outline of New York’s reopening guidance announced on Monday. Masks will be required anytime social distancing cannot be maintained, and “strongly encouraged” all other times except during meals, Gov. Andrew Cuomo said at a Monday press conference.
Faculty members working with special education students will be allowed to wear clear face shields so that they can better communicate with the children, according to a presentation to the Board of Regents.
Some of the youngest children can also be exempted. Other details about mask requirements and safety protocols will be left to local school officials. Once the full guidance is available, local district officials will have until the end of the month to develop individualized reopening plans, down to a school-by-school level, and submit them for approval. But even that does not guarantee classrooms will be open this fall. Cuomo said he will begin making reopening determinations during the first week of August.
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